Teachers are encouraged to be aware of the possibility of hearing problems which can affect attention span and concentration and so hold a child back in class. Cleft specialists have identified four other areas where cleft children may need help:

Low self-esteem

Society can sometimes have lower expectations, socially and intellectually, of someone who looks different. A pupil may have a low expectation of him/herself if he believes his peers or teachers have low expectations.

Teasing and bullying

A child born with a cleft may be subject to teasing and bullying because he or she looks or sounds different. He/she may find it harder to make friends and be a reluctant speaker in class or the playground, which may lead to withdrawal. Some children might be aggressive or disruptive to assert themselves.

Absences

Cleft children may need to be regularly absent from school to attend medical appointments or have surgery. This disrupts school life and creates pressures to keep up-to-date with work. Anxiety about being forgotten and left out by friends, and worries about what effect a change in appearance or speech due to surgery will have on how peers accept them, are common among cleft children.

Communication problems

A child who cannot make himself understood may become tactile in his efforts to communicate. This may result in fighting. Teachers and other children may not understand that this behaviour stems from a simple desire to communicate